Daily cannabis use in adolescents who smoke tobacco is associated with altered late-stage feedback processing: A high-density electrical mapping study

Impairments in feedback processing, often associated with risk-taking behavior, may have implications for development of substance abuse in adolescents. The most commonly used substances by adolescents include tobacco and cannabis, with some individuals using both substances, potentially heightening risk. Our objective was to examine feedback processing and impulsivity in adolescents who smoke cigarettes and use cannabis daily (N = 21), comparing them with adolescents who smoke cigarettes daily and use cannabis occasionally (N = 18) and non-smoking (N = 27) adolescents. To do this, the Balloon Analog Risk Task (BART) with concurrent EEG was used to measure risk-related feedback processing, and impulsivity was measured using the Barratt's impulsiveness scale (BIS-11). It was found that adolescent daily tobacco/cannabis smoking was associated with higher BIS-11 scores, shortened feedback-related-negativity (FRN) latencies and reduced P300 amplitudes. In addition, FRN latencies during win conditions were inversely associated with tobacco-use severity, indicated by scores on the Fagerstrom Test for Nicotine Dependence (FTND), and with BIS-11 scores. Adolescents with concurrent tobacco and cannabis use show altered feedback processing and higher impulsivity. Future work should disentangle whether the effect reflects risk, consequences of use or both.